Under The Knife

LCS Injury Reports

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Mike Mussina's elbow. Randy Johnson's back. Bartolo Colon's shoulder. Larry Walker's neck. John Smoltz's shoulder. I could go on and on, just talking about the injuries that have made news in the four series we've seen so far. Injuries cost teams championships. Even more so, not understanding the implications of various injuries, and the limitations and fatigue they cause, can cost a team opportunities and skew matchups.

Too many teams will end the season scratching their head, wondering why they're not in the World Series. Too many times, they could just ask their medical staff. I'm not sure if you'll hear the names Ned Bergert, Barry Weinberg, Herm Schneider or David Labossiere during either of the League Championship Series; of course, if you do, something's gone wrong. They'll get their playoff shares--likely nearly the size of their annual salaries--while being an ignored part of major league baseball. I'm honored to name them and cover their work.

Chicago White Sox

I looked through the Chicago Tribune to see if Ozzie Guillen had won the Powerball, had a nice run at Sportsman's Park, or had been in Vegas during his off days. Since I see no evidence that Guillen is running on pure luck or a deal with the devil, I'll assume that he knows what he's doing. One thing that's making Ozzie look smart is having all his players out on the field in a healthy, productive state.

The only concern that the Sox have is Scott Podsednik, still dealing with a groin that will not fully heal while he's playing. The rest will help, only to the extent that 70% is less comfortable than 75%. He won't be the pesky running threat that he is when his instincts and intact groin allow him to make the quick first step he needs to steal. He appears to be fine in the field, though he wasn't tested significantly. Aaron Rowand's free range fielding protects both Podsednik and the slowed Jermaine Dye from the need to move much. There have been some interesting internal discussions about the wind patterns at US Cellular here at BP, something the White Sox staff pointedly refused comment on.

The pitching staff has no significant concerns, though they do seem limited in some ways. Guillen and pitching coach Don Cooper appear fixated on the 120 pitch mark, not letting their starters go much beyond that at any point in the season. The patterns shown by all four of their starters over the last month indicate that the pitchers are tiring earlier, beginning to be hit harder around the 80 mark, making efficiency even more important for their success and to keep the bullpen from becoming overexposed. Earl Weaver used to say that when a pitcher was tired, the hitters would tell you. That holds true here.

Herm Schneider and his staff have kept this team relatively healthy all season long and, outside of the Frank Thomas situation, there have been no significant injuries. As with the Angels in 2002 and the Marlins in 2003, the lack of significant injuries is a major part of why things have gone right for the White Sox. Schneider is the dean of baseball athletic trainers, the only non-certified trainer left. (He's allowed to continue under a grandfather clause. This fact should not in any way connote that Schneider is not qualified.) It's his work that has been a major factor in making success possible for this team.

Los Angeles Angels

Now that the $200 million team is vanquished, can we stop saying that teams buy the World Series? The Angels are just as guilty of spending big, with Bartolo Colon, Steve Finley and Vladimir Guerrero all coming over after Arte Moreno wrote big checks. Guerrero may end up being one of the all-time bargains, but don't forget that he was signed cheaply due to questions about his back. It was a risk that the Angels undertook knowing that Ned Bergert and his staff had a nice track record (and that Guerrero's injury shouldn't have scared anyone off given the facts.)

The Angels now face an uncertain future. Bartolo Colon left Game Five with what the team is calling an "inflamed right shoulder." This was a clear cascade injury that Colon was tipping as early as the warm-ups. Colon stepped off the rubber several times and shook his shoulder, took it in circles, and twice did a behind the head stretch. All of these indicate a rotator cuff problem and controlling this inflammation will be key to his availability. Colon was examined in the clubhouse by team phyisican Lewis Yocum after leaving the game. The team will have an MRI done in hopes that a decision can be made regarding the roster for the ALCS. There's no clear alternative for the roster slot. Complicating matters is the continued illness of Jarrod Washburn. His flu-like symptoms scratched him from Game Four and have him as the rough equivalent of "probable." That leaves Paul Byrd as the Game One starter, not exactly the intimidating establisher that a team wants. John Lackey on a second start with three days rest is another possibility, though one that is decidedly less risky if Lackey continues focusing on efficiency in those starts. Getting Washburn back is key, making it possible to use Ervin Santana in the Game Four slot at home.

The bullpen faces some fatigue issues. You might have noticed Francisco Rodriguez grimacing and shaking his arm at times. His fastball hasn't come back since his mid-season DL stint, forcing him to throw slider after filthy slider, taking an enormous toll on his shoulder and elbow. Kelvim Escobar also appears to be extended due to the back-to-back appearances and his elbow not being at full strength. This could put more of a load on Scot Shields and Brendan Donnelly for the ALCS than we saw in the five-game set just completed.

The team is relatively healthy on the field. Garret Anderson has some ongoing issues with his back and possibly some lingering effects of the arthritis that limited him last season. It hasn't affected his bat. Ben Molina is surely still feeling the shot he took off his left elbow--one I was sure had fractured it--but his play contradicts that. The Angels made it to the World Series just a few years ago due to a year where they were nearly the best team in the league at preventing injuries. While hardly fluky--the Angels are seldom out of the top half--it's going to be their ability to keep their pitchers effective that will decide if beating the Yankees was as close as they get to a title.

St. Louis Cardinals

Do we know any more about the Cardinals after three games with the Padres than we did before them? The Cardinals have a monster lineup, a weak but well-defined bench, a solid if not deep rotation, and some injury problems.

The biggest issue that the Cardinals face is keeping Larry Walker on the field and productive. The team has already gone a bit further than normal with the cortisone spikes to his cervical spine, but Walker has a hockey mentality that will keep him on the field. That's just step one--he has to be well enough to play. At what point does a limited Walker become less than a full-strength So Taguchi? Walker had an injury-addled .216 MLVr this season while Taguchi, his likely replacement, had a .016 MLVr. Unfortunately, using MLVr or VORPr without making significant adjustments is meaningless, but we can say with certainty that Walker would have to be well below 50% to be worse than Taguchi. This leaves open the possibility that Walker would be worse than Taguchi--or John Mabry. I won't try and defend the math, but only John Rodriguez, who had a .147 MLVr in limited play would be better than two-thirds of a Walker.

Which brings us to why Tony La Russa and Dave Duncan make the big bucks. As frustrating as their constant matchup shifts can be to watch, they're worse for the opposition. The Cardinals don't have a Jose Oquendo on the field--he's coaching third--but they also don't have a player outside of Mabry that can adequately (and I use the term loosely) be thrown around the diamond in the way that Oquendo or Chone Figgins can. The short nature of the matchup arms that La Russa has at his disposal causes him to go to eleven and leave his bench short and without a multi-positional multiplier.

The bullpen itself could be tested in a game where the starter is blown out early or if we get another Astros-Braves Game Five-style marathon. This team isn't built to survive that usage and because of its potent attack, it hasn't had to. A pitcher isn't tested when he's cruising, with a five run lead spotted to him before he heads to the mound. Expect the pitching to look good until the Astros happen to get to one of them, much in the way that the Astros bullpen was exposed after Roger Clemens couldn't go deep.

Houston Astros

I had a column written in my head by the 14th inning Sunday about how fatigue was the biggest unknown in pitching. Seeing two bullpens extended so much almost helped me make the point, until Chris Burke put one in the seats, ruining the effect we would have surely seen had their been a Game 5.

During the season, a pitcher goes from a theoretical 100%--the place where he is physically as good as he gets, able to make all his pitches without limitation and at full velocity--down to a failure level. That failure level is the point where he is unable to effectively make major league quality pitches. This is both a physical question and one of his stuff. Give me ten days rest and I still won't be able to sneak my 82 mph, no-movement fastball past a quality hitter. The starting pitcher is then asked to recover in the space of three, four, or more days back up to as near his 100% level as possible. Then, he's asked to repeat the process thirty or more times a season. The jagged sawtooth pattern you see would likely show that some pitchers get quickly back up to their 100% and stay roughly in the same "trading range" the entire season, allowing them to maintain effectiveness through the long season and even into the playoffs.

The effect is just as sure but much less predictable on a reliever. He throws at a sprinter's pace, rather than the more measured rhythm of the starter. He warms up and doesn't get in, something pitching coaches humorously call "dry humping." He throws one pitch and then heads to the showers. He throws multiple days, then not at all for a week. There is no regular pattern, even for the closers and role-limited relievers used in the most strict of situations. Moreover, almost all relievers are failed starters. The Astros' Brad Lidge was an ace starter at Notre Dame, then only came to relief after a pair of arm surgeries. Lidge, like many, couldn't hold up under the workload of a professional starter but has succeeded as an oft-used reliever. This would suggest, along with the injury free years that Dennis Eckersley and John Smoltz experienced, that the multiplier for high-leverage, high-stress innings is higher than many expected. This would also suggest that we're not using relievers enough. It would finally suggest that there's a lot more research to be done on the effects of fatigue.

The usage of their bullpen is really their only concern. Roger Clemens proved himself healthy with his relief appearance, and Jeff Bagwell is being used optimally. There's only a slight question about Lance Berkman and his mobility. All that said, it's fatigue, not injury, that will be much more important for the Astros in deciding if their talent can do what they came oh-so-close to doing last year. If there is a difference, it's that Andy Pettitte will be on the mound, not the disabled list for this year's tilts.

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We may never know the full story on Jake Peavy now that the Padres are out of the playoffs. Peavy, like Mark Mulder a few years ago, is supposed to have been healthy enough to pitch if the series had gone to a game four. While possibly true, it's a bit too convenient, akin to a medhead "my dog ate my homework." There are as many stories about Peavy circulating as there were about Mulder. If it's a simple fracture, then there's no concerns. If the team was disguising a shoulder injury as reliable sources have told me, he'll be like Mulder was--a red flag until he proves he's healthy in spring training.